How does a pathologist make a diagnosis? 2009

Gil Patrus Pena, and José de Souza Andrade-Filho
Servico de Anatomia Patologica, Hospital Felicio Rocho, Belo Horizonte, Minas Gerais, Brazil. gilpena@gold.com.br

A pathologic diagnosis is the result of a complex series of activities, mastered by the pathologist. The nature of these activities is, however, rarely talked about in depth. The medical literature occasionally discusses aspects of the pathologic diagnosis processes, generally departing from the pathologic practice. The lack of a model makes discussions about the subject a matter of preference or personal style. Educational programs are largely based on the apprenticeship model, and the development of specific abilities rests on the personal aspects of both apprentice and mentor. A model for the pathologic diagnostic process is proposed. The process of diagnosis can be viewed as an action plan, encompassing 4 domains: (1) cognitive, (2) communicative, (3) normative, and (4) medical conduct. The cognitive domain involves processes of perception, attention, memory, search, hypothesis creation, and verification, among others. Communicative skills consist of providing arguments in support of a diagnostic conclusion, with adequate clinical and relevant pathologic information. Pathologic diagnosis is also subject to technical rules (based on empirical experiences), rules of rational choice (strategies aiming at definite goals), and consensual rules among peers. Finally, the pathologic diagnosis has to be evaluated in the sphere of medical conduct, from the perspectives of both the pathologist and the referring clinician. An understanding of the diagnostic process from a theoretic perspective will benefit pathology as a science and a medical specialty because it provides the basis for understanding diagnostic variations and discrepancies. Pathologic difficulties or errors can be mapped, allowing the institution of specific remedies. This model may also enhance training and educational strategies because specific emphasis can be directed toward a particular difficulty.

UI MeSH Term Description Entries
D008611 Mentors Senior professionals who provide guidance, direction and support to those persons desirous of improvement in academic positions, administrative positions or other career development situations. Mentorships,Mentor,Mentorship
D010336 Pathology A specialty concerned with the nature and cause of disease as expressed by changes in cellular or tissue structure and function caused by the disease process. Pathologies
D003071 Cognition Intellectual or mental process whereby an organism obtains knowledge. Cognitive Function,Cognitions,Cognitive Functions,Function, Cognitive,Functions, Cognitive
D003933 Diagnosis The determination of the nature of a disease or condition, or the distinguishing of one disease or condition from another. Assessment may be made through physical examination, laboratory tests, or the likes. Computerized programs may be used to enhance the decision-making process. Diagnose,Diagnoses and Examination,Antemortem Diagnosis,Diagnoses and Examinations,Examinations and Diagnoses,Postmortem Diagnosis,Antemortem Diagnoses,Diagnoses,Diagnoses, Antemortem,Diagnoses, Postmortem,Diagnosis, Antemortem,Diagnosis, Postmortem,Examination and Diagnoses,Postmortem Diagnoses
D004503 Education, Medical, Graduate Educational programs for medical graduates entering a specialty. They include formal specialty training as well as academic work in the clinical and basic medical sciences, and may lead to board certification or an advanced medical degree. Medical Education, Graduate,Education, Graduate Medical,Graduate Medical Education
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D017145 Models, Educational Theoretical models which propose methods of learning or teaching as a basis or adjunct to changes in attitude or behavior. These educational interventions are usually applied in the fields of health and patient education but are not restricted to patient care. Educational Models,Instructional Models,Educational Model,Instructional Model,Model, Educational,Model, Instructional,Models, Instructional

Related Publications

Gil Patrus Pena, and José de Souza Andrade-Filho
October 1967, Archives of pathology,
Gil Patrus Pena, and José de Souza Andrade-Filho
January 2008, Tijdschrift voor diergeneeskunde,
Gil Patrus Pena, and José de Souza Andrade-Filho
January 2014, European journal of obstetrics, gynecology, and reproductive biology,
Gil Patrus Pena, and José de Souza Andrade-Filho
September 2008, Human pathology,
Gil Patrus Pena, and José de Souza Andrade-Filho
December 2005, Clinics in perinatology,
Gil Patrus Pena, and José de Souza Andrade-Filho
January 1973, Medical times,
Gil Patrus Pena, and José de Souza Andrade-Filho
May 1995, Osterreichische Krankenpflegezeitschrift,
Gil Patrus Pena, and José de Souza Andrade-Filho
September 2006, Autism : the international journal of research and practice,
Gil Patrus Pena, and José de Souza Andrade-Filho
March 1973, The American journal of the medical sciences,
Gil Patrus Pena, and José de Souza Andrade-Filho
December 1991, Science (New York, N.Y.),
Copied contents to your clipboard!